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KMID : 1103920080140010089
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Korean Journal of Hepatology
2008 Volume.14 No. 1 p.89 ~ p.96
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Hepatic myelopathy as a presenting neurological complication in patients with cirrhosis and spontaneous splenorenal shunt
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Koo Ja-Eun
Lim Young-Suk
Myung Sun-Jung
Suh Kyung-Suk
Kim Kang-Mo
Lee Han-Chu
Chung Young-Hwa
Lee Yung-Sang
Suh Dong-Jin
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Abstract
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Hepatic myelopathy is a rare complication of chronic liver disease that is associated with extensive portosystemic shunts. The main clinical feature of hepatic myelopathy is progressive spastic paraparesis in the absence of sensory or sphincter impainn1ent. Early and accurate diagnosis of hepatic myelopathy is important because patients with early stages of the disease can fully recover following liver transplantation. Motor-evoked potential studies may be suitable for the early diagnosis of hepatic myelopathy, even in patients with preclinical stages of the disease. Here we describe two patients who presented with spastic paraparesis associated with a spontaneous splenorenal shunt and without any previous episode of hepatic encephalopathy. One patient experienced improved neurologic symptoms after liver transplantation, whereas the other patient only received medical treatment, which did not prevent the progression of spastic paraparesis. (Korean J Hepatol 2008;14:89-96)
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KEYWORD
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Hepatic myelopathy, Liver cirrhosis, Splenorenal shunt
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